[Heart and lung in X-ray images : Lost art (?)]. / Herz und Lunge im Röntgenbild : Lost Art (?).

ABSTRACT

BACKGROUND: Echocardiography is the standard for the diagnosis of heart diseases. Nevertheless, thoracic X­ray is a frequently used examination method, also for questions regarding the cardiac situation of patients. QUESTION How relevant is the conventional radiological assessment of heart disease? MATERIALS AND METHODS: Long-known knowledge about pathophysiology of heart disease and its radiological correlation are discussed. RESULTS: Knowledge of the normal anatomy of the heart is a basic prerequisite for the assessment of pathologies. For the question of heart disease, it is essential to also assess the pulmonary vascularization. The size of the entire heart and the individual cardiac cavities is assessed by direct and indirect signs, such as heart-lung ratio, cava triangle, vascular pedicle or the size of the aorta and of the main pulmonary artery. The most common cause of heart enlargement is valve disease, which shows various conventional radiological images. CONCLUSION: Conventional thoracic radiography still plays a central role in the diagnosis of cardiopulmonary diseases and is an important diagnostic tool for quickly obtaining an overview of the patient's cardiopulmonary situation. The interplay between physiology and X­ray symptoms is complex, so close attention should be paid not only to the heart anatomy and configuration, but also primarily to the pulmonary blood flow.